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Married Women Are Among Most Vulnerable To HIV


In the face of gender inequality, married women are among most vulnerable to HIV

A lively debate at ICAAP last Wednesday 22 August ended in the conclusion that in countries with high levels of gender inequality, such as Papua New Guinea, the ABC approach on its own - Abstinence, Be Faithful and Condoms - is ineffective in reducing HIV infection.

'Contributing factors which undermine abstinence include high levels of sexual violence against women and young girls, incest, and sex under the influence of alcohol and drugs, as well as the demands of daily living costs forcing women into commercial sex and extramarital sex,' said Kritoe Jinn Keleba of the PNG Institute of Medical Research at the session 'Identity in Gender and Sexuality'.

'Moreover, cultural complexities in the use of sexual language, youth culture and cultural rituals involving sex are further challenges to abstinence. In the PNG context, abstinence is practically futile. Therefore, a more profound and achievable model [of prevention] should be incorporated into PNG's response to HIV. I believe reducing HIV infection should include promoting 100 per cent condom use and the lifting of cultural taboos associated with the use of sexual language to enable effective HIV awareness and the dissemination of related information.'

In a parallel session, 'Violence and Risk: Identifying and Reducing Vulnerabilities', participants were reminded that married women are one of the most vulnerable groups to HIV in PNG. Barbara Kepa, also of the PNG Institute of Medical Research, explained that women in PNG, having had their relationship officiated with bride price, have little or no ability to negotiate for safer sex. Husbands are frequently required to leave the village for long periods to look for work, and they engage in unsafe extramarital sex. Kepa said, 'Negotiating safer sex in a marriage can be more difficult because it implies unfaithfulness and husbands may become angry and violent, raping their wives. Furthermore, due to the poor economic situation some married women turn to [commercial] sex as a means of survival.'

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The situation was personalised in a powerful story told by Maura Mea of the PNG organisation Igat Hope. Mea described how anger and violence were features of her married life as a young woman. When she was diagnosed with HIV before her husband was, he blamed her for the infection, yet she 'found out afterwards that he had a string of girlfriends and had been involved in gang rapes'. Mea reiterated the role of bride price, saying, 'I had a traditional marriage and my husband paid the bride price so this made it very difficult to get out of this violent relationship.'

Mea's moving story put a face to gender-based violence in our region in the only truly Pacific session of the 8th ICAAP - a symposium called 'Gender Violence in the Pacific: Breaking the Silence', organised by UNAIDS. Other speakers said that empowerment for women was a critical part of addressing their vulnerability and referred to strategies such as income-generation schemes for women or Stepping Stones training as potential approaches towards becoming empowered. They also highlighted an urgent need to increase women's access in the Pacific to female controlled safe sex methods, such as female condoms.

[This press release below is based on notes made by Robyn Drysdale, Behaviour Change Communication Specialist, HIV & STI Section, Public Health Programme, SPC, who attended the 8th International Congress on AIDS in Asia and the Pacific (ICAAP) in Colombo, Sri Lanka from 19 to 23 August 2007.]

ENDS

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